Healthcare Abroad for Americans: How to Get Coverage After Leaving the US
Healthcare is the second-biggest concern Americans have about moving abroad, right after taxes. The fear is understandable — US healthcare is expensive, confusing, and tied to employment. The reality abroad is the opposite: healthcare in Brazil is dramatically cheaper, often excellent in quality, and does not require a job to access.
Here is what you actually need to know about healthcare when you leave the US for Brazil.
What Happens to Your US Health Insurance?
When you move abroad, your US health insurance — whether employer-sponsored, ACA marketplace, or Medicare — generally does not cover you internationally. Medicare explicitly does not cover care outside the United States except in very limited circumstances near the Canadian or Mexican border. If you are under 65 and on an ACA plan, you can keep it, but it will only cover emergency care abroad and at US rates, making it effectively useless for routine care in Brazil.
The practical answer is to cancel your US health insurance when you move and replace it with one of the options below. You will almost certainly pay less and get better access to care.
Option 1: Brazil's Public Healthcare System (SUS)
Brazil has a universal public healthcare system called SUS (Sistema Único de Saúde) that is free for all residents, including foreigners with legal residency. The quality varies significantly by region — in Florianópolis, the public system is generally functional for basic care, but wait times can be long and facilities range from excellent to basic. Most expats use SUS as a backup and carry private insurance for primary care.
Option 2: Brazilian Private Health Insurance (Plano de Saúde)
Private health insurance in Brazil, called a plano de saúde, is remarkably affordable by US standards. A comprehensive private plan for a healthy adult in their 30s or 40s typically costs between $80 and $200 per month — compared to $400 to $700 per month for comparable US coverage. These plans cover doctor visits, specialist consultations, lab work, hospital stays, and most procedures at private hospitals and clinics, which are generally modern, clean, and well-staffed.
In Florianópolis, major providers include Unimed, Amil, and Bradesco Saúde. You can purchase a plan directly as an individual or through a broker. Most plans require you to have a CPF (Brazil's tax ID number) and proof of residency.
Option 3: International Health Insurance
International health insurance plans — from providers like Cigna Global, Allianz Care, or SafetyWing — cover you worldwide, including both Brazil and the US. These are particularly useful if you plan to travel frequently or want the option to return to the US for major procedures. Costs range from $150 to $400 per month depending on your age, coverage level, and whether you include US coverage. Many expats exclude US coverage to reduce premiums significantly.
The Real Cost of Healthcare in Brazil
Even without insurance, healthcare in Brazil is dramatically cheaper than in the US. A visit to a private doctor in Florianópolis typically costs $30 to $80 out of pocket. A dental cleaning runs $20 to $40. An MRI at a private clinic costs $100 to $200. Many expats with low healthcare needs simply pay out of pocket for routine care and carry a catastrophic-only international plan for major emergencies.
What About Medications?
Prescription medications in Brazil are a fraction of US prices. Many common medications that cost hundreds of dollars per month in the US — including blood pressure medications, cholesterol drugs, and diabetes medications — cost $5 to $20 per month at Brazilian pharmacies. Generic medications are widely available and of good quality. You will need a Brazilian prescription for most medications, which your local doctor can provide.
Our Recommendation
For most Americans moving to Florianópolis, the best approach is a Brazilian plano de saúde for day-to-day care combined with a basic international plan that covers emergency evacuation and major procedures. Total cost: $150 to $300 per month — less than most Americans pay for US insurance alone, with better access to care and no surprise bills.